早期肺复张策略联合适应性支持通气在ICU急性呼吸窘迫综合征的应用效果  

Effect of Early Lung Recruitment Strategy Combined with Adaptive Support Ventilation on Acute Respiratory Distress Syndrome in ICU

作　　者：罗建军 张明翰 LUO Jianjun;ZHANG Minghan(People’s Hospital of Nanhai Economic Development Zone in Foshan City,Foshan 528237,China;不详)

机构地区：[1]佛山市南海经济开发区人民医院,广东佛山528237 [2]佛山市第一人民医院

出　　处：《中外医学研究》2022年第11期137-140,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究早期肺复张策略联合适应性支持通气(ASV)在ICU急性呼吸窘迫综合征(ARDS)的应用效果。方法:2020年1月-2021年9月,选取佛山市南海经济开发区人民医院ICU收治的ARDS患者98例,采取随机数字表法均分成两组,对照组49例采取ASV模式,观察组49例采取肺复张策略联合ASV模式,对比两组治疗效果。结果:两组治疗前平均动脉压(MAP)和氧合指数(PaO_(2)/FiO_(2))值比较,差异均无统计学意义(P>0.05)。观察组治疗后24、72 h和对照组治疗后72 h的MAP和PaO_(2)/FiO_(2)值均高于本组治疗前,观察组治疗后72 h的MAP和两组治疗后72 h的PaO_(2)/FiO_(2)值均较本组治疗后24 h高,且观察组治疗后24、72 h的MAP和PaO_(2)/FiO_(2)值均高于对照组,差异有统计学意义(P<0.05)。与对照组相比,观察组治疗4周后的总有效率明显更高,并发症发生率明显更低(P<0.05)。结论:早期肺复张策略联合ASV模式能够更好地改善ARDS患者血流动力学和氧合状态,预防并发症,有利于患者开展早期康复。Objective:To study the effect of early lung recruitment strategy combined with adaptive support ventilation(ASV)on acute respiratory distress syndrome(ARDS)in ICU.Method:From January 2020 to September 2021,98 patients with ARDS treated in ICU of the People’s Hospital of Nanhai Economic Development Zone in Foshan City were randomly divided into two groups.49 cases in the control group were treated with ASV mode,and 49 cases in the observation group were treated with lung recruitment strategy combined with ASV mode.The therapeutic effects of the two groups were compared.Result:There were no significant differences in MAP and PaO_(2)/FiO_(2)between the two groups before treatment(P>0.05).MAP and PaO_(2)/FiO_(2)values of the observation group at 24 hours and 72 hours after treatment and those in the control group at 72 hours after treatment were higher than those before treatment,the differences were statistically significant,and MAP values of the observation group and PaO_(2)/FiO_(2)MAP in two groups at 72 hours after treatment were higher than those at 24 hours after treatment,and MAP and PaO_(2)/FiO_(2)values of the observation group at 24 hours and 72 hours after treatment were higher than those in the control group(P<0.05).Compared with the control group,the total effective rate of the observation group after 4 weeks of treatment was significantly higher than that in control group and the incidence of complications was significantly lower than that in control group(P<0.05).Conclusion:Early lung recruitment strategy combined with ASV mode can better improve hemodynamics and oxygenation in patients with ARDS,prevent complications and facilitate early rehabilitation.

关 键 词：肺复张后呼气末正压递增法 适应性支持通气 急性呼吸窘迫综合征 并发症 临床效果 

分 类 号：R473.5[医药卫生—护理学]